By: Jeffrey Maser  May. 02, 2018
Augusta Health in Fishersville had the lowest average length of stay (LOS) for a 30-day episode of care with unplanned readmissions for patients with cardiac arrhythmia among all Virginia hospitals at 2.65 days, according to a Dexur study of CMS claims data between 2013-2016. Sentara Martha Jefferson Hospital in Charlottesville ranked 2nd at 2.88 days, followed closely by Riverside Tappahannock Hospital in Tappahannock at 2.92 days. Sentara RMH Medical Center in Harrisonburg ranked 4th at 2.99 days while Riverside Walter Reed Hospital in Gloucester rounded out the top five at 3.19 days. The average LOS for a 30-day episode of care with unplanned readmissions at these five facilities were each substantially lower than the national average of 3.95 days as well as the 3.85 day average for Virginia Medicare enrollees.
Average length of stay for a 30-day episode of care is comprised of hospital LOS for the index stay plus any additional days spent in the hospital within the first 30 days post-discharge due to an unplanned readmission. Unplanned readmissions are defined as inpatients admitted via the emergency department. It is important to note that patients are not always readmitted to the index hospital for subsequent stays. Virginia hospitals were included in the rankings if they accounted for at least 50 DRG-309 (Cardiac Arrhythmia And Conduction Disorders With Complication or Comorbidity) discharges between January 2013 - December 2016; 59 hospitals met this criteria. Discharges where the patient expired, was transferred, or was discharged against medical advice were excluded from the totals.
In addition to accounting for the lowest in-state average LOS for a 30-day episode of care with unplanned readmissions, Augusta Health also ranked 1st in average LOS for a 30-day episode of care with all readmissions, which includes unplanned readmissions as well as follow-up visits and other inpatient readmissions within the 30-day timeframe. At 2.74 days, Augusta Health was one of only two Virginia hospitals under three days for this metric. The other was Riverside Tappahannock Hospital at 2.96 days. One major contributor to Augusta Health's top rank in both of these metrics was their average LOS for the index hospital stay, which also ranked best in the state at 2.27 days. Other significant factors were the hospital's readmission rate and average LOS for any readmitted hospital stays. Augusta Health ranked 2nd in total readmission rate* at 14.6% and 7th in unplanned readmission rate* at 14.48%. The hospital ranked 3rd in average LOS for all readmitted hospital stays* at 3.21 days and 3rd in average LOS for unplanned readmitted hospital stays* at 3.19 days.
At Augusta Health, the highest volume physicians for DRG-309 were Dr. Gavin T. Slitt, Dr. John Q.A. Mattern, and Dr. Robert Ginsberg. Dr. Slitt reported 21 discharges while Dr. Mattern and Dr. Ginsberg each had 16. Dr. Slitt's average LOS for a 30-day episode of care with unplanned readmissions for DRG-309 was 2.86 days, Dr. Mattern's was 1.63 days and Dr. Ginsberg's was 2.25 days. For average LOS for a 30-day episode of care with all readmissions, Dr. Slitt had a rate of 2.95 days, while Dr. Mattern came in at 1.63 days and Dr. Ginsberg at 2.25 days. All three physicians' metrics were significantly lower than both state and national averages.
* Hospitals with <11 readmissions were excluded from this specific ranking - actual rates cannot be disclosed as per CMS privacy guidelines